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Preclinical screening for retinopathy of prematurity risk using IGF1 levels at 3 weeks post-partum
Alejandro Pérez-Muñuzuri1, Maria Luz Couce-Pico1, Ana Baña-Souto1
1Neonatology Service, Department of Paediatrics, Clinical Hospital of the University of Santiago de Compostela, Santiago de Compostela, Spain.
Insights
Measuring serum IGF1 levels and sepsis presence in premature infants can predict retinopathy of prematurity (ROP). This screening helps identify high-risk newborns for better ROP prediction and resource optimization.
Area of Science:
- Neonatology
- Ophthalmology
- Pediatric Critical Care
Background:
- Current retinopathy of prematurity (ROP) prevention requires extensive patient screening.
- Identifying high-risk infants for ROP is crucial for effective resource allocation.
Purpose of the Study:
- To develop a predictive screening system for retinopathy of prematurity (ROP).
- To determine key biomarkers for early ROP risk assessment in premature infants.
Main Methods:
- Prospective study of 145 premature newborns (<1500g birthweight or <32 weeks gestational age).
- Analysis of clinical variables including serum IGF1 levels at week 3 and sepsis presence.
- Multiple logistic regression used to identify significant risk factors for ROP.
Main Results:
- 26.9% of enrolled infants developed some form of retinopathy.
- Significant associations found between ROP and gestational age, birthweight, mechanical ventilation, oxygen, intracranial hemorrhage, sepsis, BPD, transfusions, erythropoietin, and low IGF1.
- Serum IGF1 levels and sepsis presence showed high predictive value for ROP.
Conclusions:
- Serum IGF1 levels and sepsis are strong predictors of ROP development.
- This preclinical screening method can identify high-risk infants, improving ROP prediction.
- Optimized screening enhances the efficient use of clinical resources for ROP management.
Abstract:
Following current recommendations for preventing retinopathy of prematurity (ROP) involves screening a large number of patients. We performed a prospective study to establish a useful screening system for ROP prediction and we have determined that measuring serum levels of IGF1 at week three and the presence of sepsis have a high predictive value for the subsequent development of ROP. A total of 145 premature newborn, with birthweight <1500 g and/or <32 weeks gestational age, were enrolled. 26.9% of them showed some form of retinopathy. A significant association was found between the development of retinopathy and each of the following variables: early gestational age, low birthweight, requiring mechanical ventilation, oxygen treatment, intracranial haemorrhage, sepsis during the first three weeks, bronchopulmonary dysplasia, the need for erythrocyte transfusion, erythropoietin treatment, and low levels of serum IGF1 in the third week. A multiple logistic regression analysis was used to obtain curves for the probability of developing ROP, based on the main factors linked with ROP, namely serum levels of IGF1 and presence of sepsis. Such preclinical screening has the ability to identify patients with high-risk of developing retinopathy and should lead to better prediction for ROP, while at the same time optimising the use of clinical resources, both human and material.
